2型糖尿病合并非酒精性脂肪肝患者血浆同型半胱氨酸与胰岛素抵抗相关性研究  

Correlation between serum homocysteine and insulin resistance in patients as having type 2 diabetes mellitus with concomitant non-alcoholic fatty liver disease

作　　者：张敏[1] 张剑[2] 叶晓梅[1] 

机构地区：[1]上海复旦大学附属中山医院青浦分院内分泌科,上海201700 [2]上海复旦大学附属中山医院青浦分院药剂科,上海201700

出　　处：《中国实用内科杂志》2012年第12期946-948,共3页Chinese Journal of Practical Internal Medicine

基　　金：国家自然科学基金资助项目(30800360);留学回国人员科研基金(教育部国际合作与交流司;第40批留学回国人员科研启动基金)

摘　　要：目的探讨2型糖尿病(T2DM)合并非酒精性脂肪肝(NAFLD)患者血浆同型半胱氨酸与胰岛素抵抗的关系。方法选择2011年3月至2012年3月上海复旦大学附属中山医院青浦分院内分泌科住院治疗的156例T2DM患者。按病史和B超结果分为NAFLD组(DM+N)组和非NAFLD组(DM组),另选取健康体检者65名为对照(NC)组,测定3组空腹血糖(FPG)、胰岛素(FINS)及同型半胱氨酸(HCY)等,计算胰岛素抵抗指数(HOMA-IR指数)。结果与NC组相比,DM+N及DM组空腹血糖(FPG)、空腹胰岛素(FINS)、糖化血红蛋白(HbA1c)、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、体重指数(BMI)、丙氨酸转氨酶(ALT)、HOMA-IR指数及HCY均升高(P<0.05或P<0.01)。与DM组比较,DM+N组ALT、TG、FPG、FINS、HOMA-IR指数及HCY均升高(P<0.05或P<0.01)。HOMA-IR和TG是HCY的独立危险因素。结论 T2DM合并非酒精性脂肪肝患者血浆同型半胱氨酸升高,与胰岛素抵抗存在明显相关性。Objective To investigate the correlation between serum homocysteine （HCY） and insulin resistance in patients as having type 2 diabetes mellitus （T2DM） with concomitant non-alcoholic fatty liver disease （NAFLD）. Methods We recruited 156 patients with T2DM who were admitted to department of endocrinology and metabolism ,The Qingpu Branch of Zhongshan Hospital, Fudan University, between March 2010 and March 2012. Eligible patients were subsequently allocated to groups （ DM ＋ N） and DM, respectively, based on the presence of NAFLD as diagnosed via history inquiry and ultra- sonography. A total of 65 subjects who underwent clinical health check-up were allocated in group NC. Fasting plasma glucose （FPG） ,fasting insulin （FINS） and HCY concentrations were assayed,and the insulin resistance index （HOMA-IR） was calculated. Results Higher 1 evels of FPG, FINS, glyeosylated hemoglobin （ HbA1 c ）, total glycerin （ TG）, total cholesterol （ TC ）, low-density lipoprotein-cholesterol （ LDL-C ）, body mass index （ BMI）, alanine transferrase （ ALT）, HOMA-IR and HCY were evidenced in groups （DM ＋ N） and DM （all P 〈0. 05） ,but not in group NC. Group （DM ＋ N） was associated with higher 1 evels of ALT, TG, FPG, FINS, HOMA-IR and HCY （ all P 〈 0. 05 ） as compared with group DM. Both HOMA-IR and TG were shown as the independent influencing factors of HCY. Conclusion Patients as having T2DM with concomitant NAFLD may be featured by increased plasma HCY that has been shown to correlate with IR.

关 键 词：2型糖尿病 非酒精性脂肪肝病 胰岛素抵抗 同型半胱氨酸 

分 类 号：R587.1[医药卫生—内分泌]